Stage 0 (Melanoma in Situ)
Stage I Melanoma
Stage II Melanoma
Stage III Melanoma
Stage IV Melanoma

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Treatment of stage 0 is usually surgery to remove the area of abnormal cells and a small amount of normal tissue around it.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 melanoma ¹.

Treatment of stage I melanoma may include the following:

• Surgery to remove the tumor and some of the normal tissue around it.
• A clinical trial of surgery to remove the tumor and some of the normal tissue around it, with or without lymph node mapping and selective lymphadenectomy.
• A clinical trial of new techniques to detect cancer cells in the lymph nodes.
• A clinical trial of lymphadenectomy with or without adjuvant therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I melanoma ².

Treatment of stage II melanoma may include the following:

• Surgery to remove the tumor and some of the normal tissue around it, followed by removal of nearby lymph nodes.
• Lymph node mapping and sentinel lymph node biopsy, followed by surgery to remove the tumor and some of the normal tissue around it. If cancer is found in the sentinel lymph node, a second surgical procedure can be performed to remove additional nearby lymph nodes.
• Surgery followed by high-dose biologic therapy.
• A clinical trial of adjuvant chemotherapy and/or biologic therapy, or immunotherapy.
• A clinical trial of new techniques to detect cancer cells in the lymph nodes.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II melanoma ³.

Treatment of stage III melanoma may include the following:

• Surgery to remove the tumor and some of the normal tissue around it.
• Surgery to remove the tumor with skin grafting to cover the wound caused by surgery.
• Surgery followed by biologic therapy.
• A clinical trial of surgery followed by chemotherapy and/or biologic therapy.
• A clinical trial of biologic therapy.
• A clinical trial comparing surgery alone to surgery with biologic therapy.
• A clinical trial of chemoimmunotherapy or biologic therapy.
• A clinical trial of hyperthermic isolated limb perfusion using chemotherapy and biologic therapy.
• A clinical trial of biologic therapy and radiation therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III melanoma ⁴.

Treatment of stage IV melanoma may include the following:

• Surgery or radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
• Chemotherapy and/or biologic therapy.
• A clinical trial of new chemotherapy and/or biologic therapy, or vaccine therapy.
• A clinical trial of radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
• A clinical trial of surgery to remove all known cancer.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV melanoma ⁵.

Glossary Terms

Not normal. An abnormal lesion or growth may be cancerous, premalignant (likely to become cancer), or benign.

Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy.

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Chemotherapy combined with immunotherapy. Chemotherapy uses different drugs to kill or slow the growth of cancer cells; immunotherapy uses treatments to stimulate or restore the ability of the immune system to fight cancer.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

A procedure in which a warmed solution containing anticancer drugs is used to bathe, or is passed through the blood vessels of, the tissue or organ containing the tumor.

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in immunotherapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biological therapy, biotherapy, and BRM therapy.

A procedure that may be used to deliver anticancer drugs directly to an arm or leg. The flow of blood to and from the limb is temporarily stopped with a tourniquet (a tight band around the limb), and anticancer drugs are put directly into the blood of the limb. This allows the person to receive a high dose of drugs in the area where the cancer occurred. Also called limb perfusion.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

The use of dyes and radioactive substances to identify lymph nodes that may contain tumor cells. Also called lymphatic mapping.

A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. For a regional lymphadenectomy, some of the lymph nodes in the tumor area are removed; for a radical lymphadenectomy, most or all of the lymph nodes in the tumor area are removed. Also called lymph node dissection.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

The first lymph node to which cancer is likely to spread from the primary tumor. When cancer spreads, the cancer cells may appear first in the sentinel node before spreading to other lymph nodes.

Removal and examination of the sentinel node(s) (the first lymph node(s) to which cancer cells are likely to spread from a primary tumor). To identify the sentinel lymph node(s), the surgeon injects a radioactive substance, blue dye, or both near the tumor. The surgeon then uses a scanner to find the sentinel lymph node(s) containing the radioactive substance or looks for the lymph node(s) stained with dye. The surgeon then removes the sentinel node(s) to check for the presence of cancer cells.

Skin that is moved from one part of the body to another.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal melanocytes (cells that make melanin, the pigment that gives skin its color) are found in the epidermis (outer layer of the skin). These abnormal melanocytes may become cancer and spread into nearby normal tissue. Also called melanoma in situ.

Stage I is divided into stages IA and IB. In stage IA, the tumor is not more than 1 millimeter thick, with no ulceration. The tumor is in the epidermis (outer layer of skin) and upper layer of the dermis (inner layer of skin). In stage IB, the tumor is either not more than 1 millimeter thick and it has ulceration or it has spread into the dermis or the tissue below the skin; or more than 1 but not more than 2 millimeters thick, with no ulceration.

Stage II is divided into stages IIA, IIB, and IIC. In stage IIA, the tumor is either more than 1 but not more than 2 millimeters thick, with ulceration; or more than 2 but not more than 4 millimeters thick, with no ulceration. In stage IIB, the tumor is either more than 2 but not more than 4 millimeters thick, with ulceration; or more than 4 millimeters thick, with no ulceration. In stage IIC, the tumor is more than 4 millimeters thick, with ulceration.

The tumor may be any thickness, with or without ulceration (formation of a break on the skin or surface of an organ), and either (1) has spread into a nearby lymph vessel and may have spread into nearby lymph nodes; or (2) has spread to 1 or more lymph nodes, which may be matted (not moveable).

The tumor has spread to other parts of the body.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. A vaccine can help the body recognize and destroy cancer cells or microorganisms.